Regression of giant olfactory groove meningioma and complete visual acuity recovery after discontinuation of cyproterone acetate

Purpose: To report on the medical management of meningioma with compression of the optic chiasm associated with the use of cyproterone acetate (CA). Case Report: A 65-year-old woman who was being treated with CA presented with a recent decrease in visual function, leading to discovery of a giant olfactory groove meningioma with compression of the optic chiasm. CA was discontinued immediately, and her visual function improved dramatically. At 13 months, in addition to a significant improvement in visual and neurocognitive symptoms, the tumor volume was reduced by 50%. Conclusion: In meningiomas associated with CA, treatment cessation may result in prompt improvement in symptoms and a reduction in tumor volume, even if the tumor is large and causing neurologic impairments.